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1:
Testes : Maturation Arrest
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Comments: This testicular biopsy done for infertility workup in a young male shows maturation arrest. There are numerous spermatogonia (adjoining the basement membrane), few spermatocytes and no mature spermatozoa.
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2:
Testes : Maturation Arrest
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Comments: The cells present on the luminal aspect of the tubule are Sertoli cells. This appearance can be produced by the same agents that can induce hypospermatogenesis, such as radiation, alkylating agents, gonadotropin deficiency. When complete maturation arrest is diffusely present bilaterally, the sperm count is usually zero.
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3:
Sertoli-cell-only Syndrome (Germ Cell Aplasia)
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Comments: This testicular biopsy is from a patient with normal semen volume and azoospermia. It His FSH level was elevated. The biopsy shows seminiferous tubules lined only by mature Sertoli cells. The term “wind-swept appearance” has been used to describe sertoli cells in this condition.
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4:
Sertoli-cell-only Syndrome (Germ Cell Aplasia)
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Comments: The sertoli cells have oval nuclei and punctate nucleoli. Leydig cells are usually normal in appearance but may appear to be increased in number due to reduced tubular diameter. Causes of Sertoli cell-only syndrome include: gonadotropin deficiency, cryptorchidism, viral orchitis, irradiation, alkylating agents, hormonal therapy for prostate cancer etc.
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5:
Testes : Klinefelter's Syndrome (47 XXY)
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Comments: This testicular biopsy is from an adult male with history of normal semen volume and severe oligospermia. He had small firm testes and body habitus suggestive of Klinefelter’s syndrome. The biopsy shows small hyalinized seminiferous tubules and pseudo-adenomatous clusters of leydig cells.
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6:
Testes : Klinefelter's Syndrome (47 XXY)
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Comments: Atrophy of seminiferous tubules and reduced testicular volume gives a false impression of leydig cell hyperplasia in Klinefelter’s syndrome. Studies have shown that the total number of leydig cells is actually reduced.
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7:
Testes : Klinefelter's Syndrome (47XXY)
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Comments: Couple of hyalinized seminiferous tubules surrounded by leydig cells containing abundant microvacuolated cytoplasm. Even though leydig cells may appear morphologically normal in Klinefelter’s syndrome, they are often functionally deficient and androgen levels are often reduced accompanied by elevated FSH and LH levels.
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8:
Testicular Feminization (Androgen Insensitivity Syndrome)
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Comments: A form of male pseudohermaphroditism with female phenotype and presence of testes. Karyotype is usually XY; but XXY may be seen. Seminiferous tubules have small abortive lumens and usually contain only sertoli cells. About 10% of patients with testicular feminization develop testicular cancers.
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10:
Pick's Adenoma in Cryptorchidism
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Comments: Post-pubertal cryptorchid testis showing small sclerotic tubules with thickened tunica propria and interstitial fibrosis. Such testes often show nodules of small tubules lined by sertoli cells (seen in the center of the photomicrograph) referred to as Pick’s adenoma. These are not true neoplasms.
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11:
Pick's Adenoma in Cryptorchidism
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Comments: High power view of Pick’s adenoma reveals sertoli cells with hyperchromatic nuclei lined perpendicular to the basement membrane.
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12:
Ovotestes in True Hermaphroditism
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Comments: In true hermaphroditism (characterized by the presence of both testicular and ovarian tissue), ovotestis is the most common gonad type. In this example, three ovarian follicles are seen on the left and numerous small seminiferous tubules with immature sertoli cells are seen on the right.
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13:
Ovotestes in True Hermaphroditism
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Comments: In ovotestis, the seminiferous tubules remain small and rarely may show incomplete spermatogenesis. This illustration shows hyperchromatic sertoli cells lining the tubules. Such dysgenetic gonads are prone to develop tumors, including gonadoblastoma, dysgerminoma, and yolk sac tumor.
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14:
Ovotestes in True Hermaphroditism
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Comments: The ovarian follicles in ovotestis often mature to corpus luteum in adulthood. Some hermaphrodite patients raised as females have even become mothers.
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15:
Testicular Regression Syndrome
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Comments: This left testicular remnant removed from a 3 year-old boy shows intact vas deferens and some fibroconnective tissue. He had presented with absent left testis and compensatory hypertrophy of the right testis (Monorchidism).
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16:
Testicular Regression Syndrome
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Comments: The image shows a vascularized fibrous nodule with areas of hemosiderin deposition and dystrophic calcification. The presence of vas deferens (seen in the previous image) is the most consistent finding. S E Spires et al. Testicular Regression Syndrome. Arch Pathol Lab Med. 2000; 124:694-698.
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17:
Testicular Regression Syndrome
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Comments: Besides hemosiderin and dystrophic calcification, arterious and venous vessels, adipose tissue, and nerves may be present in the testicular remnant. Most cases of monorchidism result from a vascular lesion or intrauterine torsion compromising circulation in the developing gonads.
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